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Texas ABA Therapy Guide

ABA Therapy in Texas: Medicaid, Insurance & How to Get Covered

Texas added ABA therapy to Medicaid in 2022, and state law requires most private insurers to cover it too. This guide explains how each program works, which cities have providers, and how to get your child matched with a verified ABA center.

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Where can I find ABA therapy in Texas?

ABA therapy in Texas is available through center-based and in-home providers concentrated in the Houston metro (Harris County and suburbs), Dallas-Fort Worth, Austin, and San Antonio, with regional providers in Tyler, Beaumont, Lubbock, and other cities. Most families access ABA therapy through STAR Kids Medicaid, private insurance under Texas Insurance Code Chapter 1355, or the state's Children's Autism Program (CAP). Texas became the 50th and final state to add ABA to its Medicaid benefit in February 2022, so coverage options that did not exist a few years ago are now available to many families.

Browse the full Texas ABA directory → Estimate ABA therapy cost →

ABA therapy centers in Texas by region

Texas has over 100 active ABA therapy centers across the state. Most cluster in the Houston metro and DFW, but Austin and San Antonio have strong provider bases too. Select your city to compare providers, accepted insurance, and waitlist status.

2026 access note

Texas has some of the lowest Medicaid ABA reimbursement rates in the country, and in late 2025 that led at least one large national provider, Autism Learning Partners, to announce it would stop offering ABA in Texas as of March 2026. When participating providers leave, waitlists in some metros can get longer. Confirm current availability and whether STAR Kids Medicaid is accepted when you call.

Austin

Austin and its fast-growing suburbs have a strong and expanding ABA provider base.

San Antonio

Bexar County providers serve families across the San Antonio metro.

East and South Texas

Regional centers reaching families outside the major metros.

Tell us your city and your child's needs. We will send you a shortlist of verified ABA providers.

How much does ABA therapy cost in Texas, and who pays?

Most Texas families do not pay the full out-of-pocket price for ABA. The majority access it through STAR Kids Medicaid, private insurance (which Texas law requires most plans to cover), or the state's Children's Autism Program. What you pay depends on your child's eligibility, your plan's copays and deductibles, and the number of hours per week. Use our cost tool to sketch a realistic estimate.

Estimate your out-of-pocket cost

ABA pricing depends on hours per week, setting (center vs. in-home), and how your insurance applies copays and deductibles. Our calculator gives you a realistic range before you call providers.

Open the ABA therapy cost tool

STAR Kids Medicaid

Texas Medicaid added ABA as a covered benefit in February 2022. Children enrolled in STAR Kids who have an ASD diagnosis and a referral can access ABA with no premium. Prior authorization is required.

Private insurance (Insurance Code Ch. 1355)

Texas law requires most private health plans to cover autism treatment including ABA. Plans that are self-funded by large employers (ERISA plans) are exempt from this state mandate; check your plan documents.

Children's Autism Program (CAP)

The state-funded CAP provides focused ABA at no cost to eligible families, capped at 180 hours per year. It is not a Medicaid program and has its own application process through 2-1-1.

Texas Medicaid and ABA therapy: what parents need to know

On February 1, 2022, Texas became the 50th and final state to add Applied Behavior Analysis to its Medicaid benefit. The program operates through the Texas Health Steps-Comprehensive Care Program (THSteps-CCP). Details below come from the Texas Health and Human Services Commission and the state's managed care enrollment resources.

Step 0: get an autism diagnosis first

Every ABA payment path in Texas requires a current autism spectrum disorder diagnosis before therapy can be authorized. That applies to STAR Kids Medicaid, the Children's Autism Program, and private insurance under Chapter 1355. If your child does not have a diagnosis yet, start with your pediatrician, a pediatric developmental clinic, or a licensed psychologist. Families already in STAR Kids can ask their managed care organization for a referral to a qualified evaluator.

Three stat cards showing ABA therapy annual cost in Texas by coverage type: zero dollars per year with STAR Kids Medicaid for eligible children, $124,800 per year without any coverage at 20 hours per week and $120 per hour, and a note that Texas private insurance plans must cover ABA therapy under the state autism mandate (Texas Insurance Code Chapter 1355). Source: Texas HHS STAR Kids 2026, Texas Insurance Code Chapter 1355, BACB rate data.

STAR Kids: the main program for children with disabilities

Most children with autism who qualify for Texas Medicaid are enrolled in STAR Kids, a managed care program for children age 20 and younger who receive Supplemental Security Income (SSI) or who participate in a Medicaid waiver program. STAR Kids covers both basic medical services and long-term services and supports, including ABA therapy. Each child is assigned a service coordinator who helps manage their care plan.

To access ABA through STAR Kids: verify Medicaid eligibility, obtain a current ASD diagnosis from a qualified clinician, get a referral for ABA from your child's physician, and contact your managed care organization (MCO) to begin the prior authorization process. Common MCOs include Molina, UnitedHealthcare Community Plan, Aetna Better Health, and Superior HealthPlan.

Source: Texas HHS: STAR Kids program overview and eligibility

What Texas Medicaid covers for ABA

Effective February 1, 2022, the THSteps-CCP added ABA evaluation and treatment as a covered benefit for children and youth with an ASD diagnosis enrolled in Texas Medicaid who meet program criteria. Covered services include both the initial ABA evaluation and ongoing treatment designed to improve communication, behavior, and daily living skills. Services must be medically necessary and prior authorization from the child's MCO is required before services begin.

Source: Texas HHS: Medicaid Applied Behavior Analysis flyer (PDF)

Medicaid Buy-In for Children: an option if your income is too high

If your child has a qualifying disability but your household income exceeds the standard Medicaid limit, the Medicaid Buy-In for Children program lets you purchase Medicaid coverage at a sliding-scale premium based on family income. This is a meaningful option for families with employer coverage whose private insurance has high out-of-pocket costs for ABA, since Medicaid can act as a secondary payer.

Source: Texas HHS: Medicaid Buy-In for Children

Before you rely on Medicaid coverage

This page summarizes publicly available Texas state information and is not legal or medical advice. Eligibility rules, covered services, and prior authorization requirements can change. Confirm your child's current benefits with your MCO or the Texas HHS Medicaid enrollment line at 877-782-6440 before making decisions.

Texas Children's Autism Program (CAP): focused ABA at no cost

Separate from Medicaid, the Texas HHS Children's Autism Program provides focused ABA therapy through local community contractors at no cost to eligible families. It is a narrower program than full Medicaid ABA coverage, but it is an important option for families while they wait for Medicaid approval or private insurance prior authorization.

Who qualifies

  • Child has a documented autism spectrum disorder diagnosis from a qualified professional
  • Child is between 3 and 15 years old (services end on the 16th birthday)
  • Child is a Texas resident

Program limits to know

  • Focused ABA only: targets specific behaviors, not all developmental needs
  • Limited to 180 hours within any 12-month period
  • Lifetime maximum of 720 hours per child
  • Parent training is required; 85% attendance required for child and parent

How to apply for CAP

All CAP services are delivered by contractors in communities across Texas. The simplest way to start is to call 2-1-1 or search for a contractor through 211texas.org. You can also contact the Children's Autism Program office directly.

Phone

512-438-5356

M-F, 8am-5pm CT

Email

Childrens.Autism.Program@hhs.texas.gov

Statewide referral

Call 2-1-1 or visit 211texas.org

Source: Texas HHS: Children's Autism Program

Texas private insurance mandate: Insurance Code Chapter 1355

Texas Insurance Code Chapter 1355 (Sec. 1355.015) requires most state-regulated private health insurance plans to cover autism spectrum disorder treatment, including ABA therapy. The mandate dates back to House Bill 1919 in 2007. It is separate from Medicaid and applies to families with employer-sponsored or individual market insurance.

What Chapter 1355 requires

Under Chapter 1355, health benefit plans issued or renewed in Texas must cover the diagnosis and treatment of autism spectrum disorder. Covered treatments include behavioral health treatment (including ABA), speech-language pathology, occupational therapy, and physical therapy. Plans may not impose annual or lifetime dollar limits on these benefits that are lower than limits applied to other medical and surgical benefits.

The ERISA exemption: the most important thing to check

The state mandate only applies to plans regulated by Texas. Many large employers "self-fund" their health plans, meaning the employer pays claims directly rather than buying a policy from an insurer. These self-funded plans are governed by federal ERISA law, not state law, and are exempt from the Chapter 1355 mandate. If your insurance card says "administered by" an insurance company but your employer is the actual plan sponsor, your plan may be self-funded.

To find out: ask your HR department whether your plan is "fully insured" or "self-funded." Fully insured plans must comply with Chapter 1355. Self-funded plans are not required to, though many still choose to cover ABA.

If your insurer denies ABA coverage

If you have a fully insured Texas plan and your insurer denies ABA, you have the right to file an internal appeal and then an external review. Texas requires plans to provide written notice of appeal rights with every denial. You can also file a complaint with the Texas Department of Insurance at 800-252-3439.

How to choose an ABA provider in Texas

Texas has a wide range of ABA providers, from national chains with dozens of locations to small independent practices. Use this checklist when comparing providers and calling for intake.

Horizontal bar chart showing recommended weekly ABA therapy hours by autism support level: high support needs ages 2 to 5 receive 35 hours per week, moderate support needs receive 20 hours per week, and lower support needs receive 12 hours per week. Source: Journal of Applied Behavior Analysis, Lovaas 1987 and subsequent replications, BACB guidelines.
These weekly hour ranges are typical starting points, not a formula. The right intensity is individualized: your child's BCBA recommends hours based on assessment, goals, and how your child responds, and the hours your plan authorizes may differ.
Setting and schedule
  • Center-based, in-home, school-based, or telehealth
  • Full-day, half-day, or after-school hours
  • Drive time across the Houston or DFW metro
Clinical model
  • BCBA-to-child ratio and how often the BCBA observes sessions
  • Whether RBTs deliver the day-to-day sessions
  • Parent training built into the program
Access and timing
  • Current waitlist length
  • Whether an autism diagnosis is required before intake
  • Whether evaluations are available in-house
Payment fit
  • Whether STAR Kids Medicaid is accepted
  • Which commercial plans the center accepts (and whether prior auth is handled in-house)
  • Sliding-scale or self-pay options if coverage is pending

Compare providers across nearby cities

In the Houston metro, providers in Pearland, Katy, and The Woodlands often have shorter waitlists than central Houston. In DFW, families in Plano or Carrollton sometimes find faster intake than Dallas proper. It is worth checking two or three nearby cities before committing to a waitlist.

Frequently Asked Questions About ABA Therapy in Texas

Does Texas Medicaid cover ABA therapy?
Yes. Effective February 1, 2022, Texas added ABA evaluation and treatment as a covered benefit under the Texas Health Steps-Comprehensive Care Program for children with an ASD diagnosis who are enrolled in Texas Medicaid. Most children with disabilities access this through STAR Kids managed care. Prior authorization from your managed care organization is required before services begin. See the Texas HHS Medicaid ABA coverage flyer (PDF) for current program details.
What is STAR Kids and does it cover ABA?
STAR Kids is a Texas Medicaid managed care program for children age 20 and younger who receive SSI or who participate in a Medicaid waiver program. It covers basic medical services and long-term services and supports, including ABA therapy for children with autism. Each child enrolled in STAR Kids is assigned a service coordinator. To access ABA, you need a current ASD diagnosis, a physician referral, and prior authorization from your STAR Kids managed care organization.
What is the Texas Children's Autism Program (CAP)?
CAP is a Texas HHS-funded program that provides focused ABA therapy at no cost to eligible children ages 3-15 with a documented ASD diagnosis. It is not a Medicaid program. Services are capped at 180 hours per year and 720 hours lifetime. Parent participation is required. To apply, call 2-1-1 or search for a contractor at 211texas.org. CAP is a useful bridge while families wait for Medicaid approval or insurance prior authorization.
Does Texas require private insurance to cover ABA?
Yes, for most plans. Texas Insurance Code Chapter 1355 (Sec. 1355.015) requires fully insured health plans to cover autism treatment including ABA. The key exception is self-funded ERISA plans, which are common among large employers and are governed by federal law, not state mandates. Ask your HR department whether your plan is "fully insured" or "self-funded" to know whether the mandate applies. If your fully insured plan denies ABA, you have the right to appeal and to request external review. Contact the Texas Department of Insurance at 800-252-3439 if you need assistance.
How do I find ABA therapy in Houston or Dallas?
Use the city links in the regions section above. For Houston, start with Houston and compare nearby suburbs like Pearland, Katy, and The Woodlands, where wait times are sometimes shorter. For DFW, check Dallas, Plano, and Carrollton. You can also ask us to match you with verified providers who accept your insurance.
What can I do if my ABA claim is denied?
A denial is not the end of the road. On a fully insured Texas plan you can file an internal appeal, and if that is unsuccessful, request an independent external review. Texas requires plans to include written appeal instructions with every denial. Denied ABA is often overturned at the appeal or external-review stage, especially when the request is backed by the BCBA's assessment and treatment plan. You can also contact the Texas Department of Insurance at 800-252-3439 for help.

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